Ukuhlinzwa Kwenhliziyo

-Delile

• Yiziphi izinhlobo ezahlukahlukene zenhliziyo ezedlula ukuhlinzwa?
• Kungani umuntu engadinga ukuhlulwa yinhliziyo?
• Sinqunywa kanjani isidingo sokuhlinzwa kokudlula kwenhliziyo?
• Ziyini izingozi zokuhlinzwa kwenhliziyo ngokudlula?
• Yiziphi ezinye izindlela zokuhlinza ngenhliziyo?
• I-balloon angioplasty
• Ukuqiniswa kwangaphandle okuthuthukisiwe (i-EECP)
• Imithi
• Izinguquko zokudla nezindlela zokuphila
• Ngikulungiselela kanjani ukuhlinzwa kwenhliziyo?
• Amathiphu wokuhlinzwa kwenhliziyo
  
• Kwenziwa kanjani ukuhlinzwa kwenhliziyo?
• Isinyathelo sokuqala
• Ixhuma kumshini wokudlula we-cardiopulmonary
• Ukuxhunyelelwa
• Izinyathelo zokugcina
• Ngubani ozosiza ukwenza ukuhlinzwa okudlula?
• Kunjani ukululama ekuhlinzweni kwenhliziyo ngokudlula?
• Kufanele ngitshele nini udokotela wami ngezinhlungu ngemuva kokuhlinzwa?
• Imiphi imishanguzo engizoyiphuza ngemuva kokuhlinzwa kwenhliziyo?
• Iyini imiphumela yesikhathi eside yokuhlinzwa okudlula?

Kuyini ukuhlinzwa kokudlula inhliziyo?

Ukuhlinzwa kokudlula kwenhliziyo, noma ukuhlinzwa kwegazi (CABG), kusetshenziselwa ukuthuthukisa ukugeleza kwegazi kuye enhliziyweni yakho. Udokotela ohlinzayo usebenzisa imithambo yegazi ethathwe kwenye indawo yomzimba wakho ukudlula imithambo eyonakele.

Odokotela benza ukuhlinza okunjalo okungaba ngu-200 000 e-United States unyaka ngamunye.

Lokhu kuhlinzwa kwenziwa lapho imithambo yegazi yenhliziyo ivimba noma ilimala. Le mithambo inikeza inhliziyo yakho ngegazi elinomoya-mpilo. Uma le mithambo ivinjiwe noma ukugeleza kwegazi kuvinjelwe, inhliziyo ayisebenzi kahle. Lokhu kungaholela ekuhlulekeni kwenhliziyo.

Yiziphi izinhlobo ezahlukahlukene zenhliziyo ezedlula ukuhlinzwa?

Udokotela wakho uzoncoma uhlobo oluthile lokuhlinzwa ngokudlula kuye ngokuthi imithambo yakho engakanani ivinjelwe.

• Ukudlula okukodwa. Umthambo owodwa kuphela uvinjelwe.
• Ukudlula kabili. Imithambo emibili ivinjiwe.
• Ukudlula kathathu. Imithambo emithathu ivinjiwe.
• Ukudlula kane. Imithambo emine ivinjiwe.

Ingozi yakho yokuhlaselwa yisifo senhliziyo, ukwehluleka kwenhliziyo, noma enye inkinga yenhliziyo incike kwinani lemithambo evinjiwe. Ukuvinjelwa kwemithambo eminingi kusho nokuthi ukuhlinzwa kungathatha isikhathi eside noma kube nzima kakhulu.

Kungani umuntu engadinga ukuhlulwa yinhliziyo?

Lapho impahla esegazini lakho ebizwa ngokuthi i-plaque yakhela phezu kwezindonga zakho zemithambo yegazi, igazi elincane ligelezela emsipheni wenhliziyo. Lolu hlobo lwesifo semithambo yegazi (CAD) saziwa njenge-atherosclerosis.

Inhliziyo inamathuba amaningi okuthi ikhathele futhi yehluleke uma ingatholi igazi elanele. I-atherosclerosis ingathinta noma imiphi imithambo yegazi emzimbeni.

Udokotela wakho angancoma ukuhlinza inhliziyo uma imithambo yegazi yakho incipha kakhulu noma ivinjwe kangangokuthi ubeka engcupheni enkulu yokuhlaselwa yisifo senhliziyo.

Udokotela wakho uzophinda ancome ukuhlinzwa ngokudlula lapho ukuvinjelwa kunzima kakhulu ukuphatha ngemithi noma ezinye izindlela zokwelapha.

Sinqunywa kanjani isidingo sokuhlinzwa kokudlula kwenhliziyo?

Ithimba lodokotela, kufaka phakathi udokotela wenhliziyo, likhomba ukuthi ungakwazi yini ukuhlinzwa ngenhliziyo evulekile. Ezinye izimo zezokwelapha zingaba nzima ukuhlinzeka noma zikuqede njengokungenzeka.

Izimo ezingadala izinkinga zifaka:

• isifo sikashukela
• emphysema
• isifo sezinso
• isifo se-peripheral arterial (PAD)

Xoxa ngalezi zinkinga nodokotela wakho ngaphambi kokuhlela ukuhlinzwa kwakho. Uzophinde ufune ukukhuluma ngomlando wakho wezokwelapha womndeni kanye nanoma imiphi imishanguzo kadokotela oyisebenzisayo. Imiphumela yokuhlinzwa ehleliwe ivame ukuba ngcono kunokuhlinzwa okuphuthumayo.

Ziyini izingozi zokuhlinzwa kwenhliziyo ngokudlula?

Njenganoma yikuphi ukuhlinzwa kwenhliziyo evulekile, ukuhlinzwa kwenhliziyo kudlula nezingozi. Intuthuko yezobuchwepheshe yakamuva ithuthukise inqubo, yandisa amathuba okuhlinzwa ngempumelelo.

Kusekhona ingozi yezinkinga ezithile ngemuva kokuhlinzwa. Lezi zinkinga zingabandakanya:

• ukopha
• i-arrhythmia
• amahlule egazi
• ubuhlungu besifuba
• ukutheleleka
• ukwehluleka kwezinso
• isifo senhliziyo noma isifo sohlangothi

Yiziphi ezinye izindlela zokuhlinza ngenhliziyo?

Kule minyaka eyishumi edlule, sekutholakele ezinye izindlela zokuhlinza ngokudlula kwenhliziyo. Lokhu kufaka phakathi:

I-balloon angioplasty

I-balloon angioplasty iyona ndlela okungenzeka ukuthi inconywe ngodokotela. Ngesikhathi salokhu kwelashwa, kufakwa ishubhu ngomthambo wakho ovinjiwe. Ngemuva kwalokho, kubhaliswa ibhaluni elincane ukuze kunwetshwe umthambo.

Udokotela ube esekhipha ishubhu nebhaluni. Isikafula esincane sensimbi, esaziwa nangokuthi i-stent, sizosala endaweni. I-stent igcina umthambo ungangeni enkontilekeni ubuyele kusayizi wawo wokuqala.

I-balloon angioplasty ingahle ingasebenzi njengokuhlinzwa kokuhlinzwa kwenhliziyo, kodwa ayinabungozi kangako.

Ukuqiniswa kwangaphandle okuthuthukisiwe (i-EECP)

Ukuqiniswa kwangaphandle okuthuthukisiwe (i-EECP) kuyinqubo yokugula kwabangaphandle. Kungenziwa ngokuhlinzwa kokuhlinzwa kwenhliziyo, ngokusho kokuningi. Ngo-2002, kwavunywa yi-Food and Drug Administration (FDA) ukuthi isetshenziswe kubantu abane-congestive heart failure (CHF).

I-EECP ifaka ukucindezela imithambo yegazi ezingalweni ezingezansi. Lokhu kwandisa ukugeleza kwegazi kuye enhliziyweni. Igazi elengeziwe lilethwa enhliziyweni ngakho konke ukushaya kwenhliziyo.

Ngokuhamba kwesikhathi, eminye imithambo yegazi ingakha “amagatsha” athe xaxa azoletha igazi enhliziyweni, abe luhlobo “lokudlula” kwemvelo.

I-EECP ilawulwa nsuku zonke isikhathi sehora elilodwa kuya kwamabili phakathi namasonto ayisikhombisa.

Imithi

Kunemithi ethile ongayicabangela ngaphambi kokusebenzisa izindlela ezinjengokuhlinzwa kwenhliziyo ngokudlula. I-beta-blockers ingakhulula i-angina ezinzile. Ungasebenzisa izidakamizwa ezinciphisa i-cholesterol ukubamba ukwakheka koqwembe emithanjeni yakho.

Udokotela wakho futhi angancoma umthamo wansuku zonke we-aspirin yedosi ephansi (i-aspirin yengane) ukusiza ukuvimbela ukuhlaselwa yinhliziyo. Ukwelashwa kwe-Aspirin kusebenza kahle kubantu abanomlando wangaphambilini wesifo senhliziyo nesifo senhliziyo (njengokuhlaselwa yinhliziyo noma isifo sohlangothi).

Labo abangenawo umlando wangaphambilini kufanele basebenzise kuphela i-aspirin njengesidakamizwa sokuvikela uma:

• zisengozini enkulu yokuhlaselwa yisifo senhliziyo nezinye izifo zenhliziyo nemithambo yegazi
• futhi unengozi encane yokopha

Izinguquko zokudla nezindlela zokuphila

Isilinganiso esihle kakhulu sokuzivikela indlela yokuphila enempilo, njengoba kuchazwe yi-American Heart Association (AHA). Ukudla ukudla okunama-omega-3 fatty acids amaningi kanye namafutha amancane agcwele futhi kusiza inhliziyo yakho ukuthi ihlale iphilile.

Ngikulungiselela kanjani ukuhlinzwa kwenhliziyo?

Uma udokotela wakho ancoma ukuhlinzwa kokudlula kwenhliziyo, bazokunikeza imiyalo ephelele yokuthi ungazilungiselela kanjani.

Uma ukuhlinzwa kuhlelwe kusengaphambili futhi akuyona inqubo ephuthumayo, cishe uzoba nokuqokwa kokuqala kokuhlinzwa lapho uzobuzwa ngomlando wakho wezempilo nowezempilo womndeni.

Uzobuye uvivinywe kaningana ukusiza udokotela wakho athole isithombe esinembile ngempilo yakho. Lokhu kungafaka:

• ukuhlolwa kwegazi
• X-ray esifubeni
• i-electrocardiogram (ECG noma i-EKG)
• i-angiogram

Amathiphu wokuhlinzwa kwenhliziyo

• Funa iseluleko sikadokotela wakho nganoma imuphi umuthi othinta ukuthi igazi lakho ligaxeka kanjani. Imithi eminingi yokudambisa izinhlungu nemithi yenhliziyo ithinta amahlwili, ngakho-ke kungadingeka ukuthi uyeke ukuwaphuza.
• Yeka ukubhema. Kubi enhliziyweni yakho futhi kwandisa isikhathi sokuphulukiswa.
• Tshela udokotela wakho uma unezimpawu zomkhuhlane noma umkhuhlane. Ikakhulukazi, umkhuhlane ungabeka ubunzima enhliziyweni futhi ungakhuphula amathuba okuhlaselwa yisifo senhliziyo noma wenze inhliziyo yakho ibe yimbi. Kungadala ne-myocarditis, i-pericarditis, noma kokubili. Lokhu ukutheleleka kwenhliziyo okungenzeka kube kubi kakhulu.
• Lungisa ikhaya lakho bese wenza amalungiselelo okuhlala esibhedlela izinsuku ezimbalwa.
• Ukunciphisa ubungozi bokutheleleka, geza umzimba wakho ngensipho ekhethekile, njenge-Hibiclens, ngobusuku obandulela ukuhlinzwa. Yenziwe nge-chlorhexidine, ezosiza ukugcina umzimba wakho ungenawo amagciwane kuze kube sekuhlinzwa.
• Kuyashesha, okubandakanya ukungaphuzi amanzi, ukuqala phakathi kwamabili ngaphambi kokuhlinzwa kwakho.
• Thatha yonke imithi udokotela akunikeza yona.

Kwenziwa kanjani ukuhlinzwa kwenhliziyo?

Ngaphambi kokuhlinzwa, uzoshintsha ugqoke isibhedlela bese uthola imithi, uketshezi, ne-anesthesia nge-IV. Lapho i-anesthesia iqala ukusebenza, uzolala ubuthongo obujulile, obungenabuhlungu.

Isinyathelo sokuqala

Udokotela wakho ohlinzayo uqala ngokwenza imbobo maphakathi nesifuba sakho.

Ubambo lwakho lusakazeka ngaphandle ukuze kuveze inhliziyo yakho. Udokotela wakho ohlinzayo angakhetha ukuhlinzwa okuncane, okubandakanya ukusikeka okuncane nezinsimbi ezikhethekile ezisetshenzisiwe nezinqubo zerobhothi.

Ixhuma kumshini wokudlula we-cardiopulmonary

Ungaxhunyaniswa nomshini wokudlula we-cardiopulmonary ohambisa igazi elinomoya-mpilo emzimbeni wakho ngenkathi udokotela wakho ohlinzayo esebenza enhliziyweni yakho.

Ezinye izinqubo zenziwa "off-pump," okusho ukuthi ukukuxhuma kumshini we-cardiopulmonary bypass akudingekile.

Ukuxhunyelelwa

Udokotela wakho ohlinzayo ususa isitsha segazi esinempilo emlenzeni ukudlula engxenyeni evinjiwe noma elimele yomthambo wakho. Omunye umkhawulo wokuxhunyelelwa unamathiselwe ngaphezu kokuvinjelwa kanti omunye umkhawulo ungezansi.

Izinyathelo zokugcina

Lapho udokotela wakho ohlinzayo eseqedile, umsebenzi wokudlula uyahlolwa. Lapho ukudlula eceleni kusebenza, uzothungwa, ubhandishwe, futhi uyiswe egumbini labagula kakhulu (i-ICU) ukuze liqashwe.

Ngubani ozosiza ukwenza ukuhlinzwa okudlula?

Kukho konke ukuhlinzwa, izinhlobo eziningana zochwepheshe ziqinisekisa ukuthi inqubo yenziwa kahle. Uchwepheshe we-perfusion usebenza nomshini we-cardiopulmonary bypass.

Udokotela ohlinzayo wenhliziyo wenza le nqubo futhi i-anesthesiologist iqinisekisa ukuthi i-anesthesia ihanjiswa emzimbeni wakho ngokufanele ukukugcina ungazi lutho ngesikhathi senqubo.

Ochwepheshe bokufanekisa kungenzeka babekhona ukuzothatha ama-X-ray noma ukusiza ukuqinisekisa ukuthi iqembu lingabuka indawo yokuhlinzwa nezicubu ezizungezile.

Kunjani ukululama ekuhlinzweni kwenhliziyo ngokudlula?

Lapho uvuka enhliziyweni ngokudlula ekuhlinzweni, uzoba neshubhu emlonyeni wakho. Ungase futhi uzwe ubuhlungu noma ube nemiphumela emibi evela enkambisweni, kufaka phakathi:

• ubuhlungu esizeni sokusikwa
• ubuhlungu ngokuphefumula okujulile
• ubuhlungu ngokukhwehlela

Kungenzeka ube se-ICU usuku olulodwa noma ezimbili ukuze izimpawu zakho ezibalulekile ziqashwe. Uma usuzinzile, uzothuthelwa kwelinye igumbi. Zilungiselele ukuhlala esibhedlela izinsuku ezimbalwa.

Ngaphambi kokuba uphume esibhedlela, ithimba lakho lezokwelapha lizokunikeza imiyalo yokuthi ungazinakekela kanjani, kufaka phakathi:

• ukunakekela amanxeba akho okusikeka
• ukuthola ukuphumula okuningi
• ukugwema ukuphakamisa okunzima

Ngisho ngaphandle kwezinkinga, ukululama ekuhlinzweni kwenhliziyo kungathatha amasonto ayisithupha kuye kwayi-12. Leso yisikhathi esincane esidinga ukuthi ithambo lakho lesifuba liphole.

Ngalesi sikhathi, kufanele ugweme ukuzikhandla okukhulu. Landela imiyalo kadokotela wakho maqondana nomsebenzi womzimba. Futhi, akufanele ushayele uze uthole imvume kudokotela wakho.

Udokotela wakho cishe uzotusa ukuvuselelwa kwenhliziyo. Lokhu kuzobandakanya uhlobo lwemisebenzi ebhekwe ngokucophelela yokuvivinya umzimba nokuhlolwa kwengcindezi ngezikhathi ezithile ukubona ukuthi inhliziyo yakho isinda kanjani.

Kufanele ngitshele nini udokotela wami ngezinhlungu ngemuva kokuhlinzwa?

Tshela udokotela wakho nganoma yibuphi ubuhlungu obuhlala njalo noma ukungakhululeki ngesikhathi sokuqokwa kokulandelela. Kufanele futhi ushayele udokotela wakho uma uhlangabezana:

• umkhuhlane ngaphezu kuka-100.4 ° F (38 ° C)
• ukwandisa ubuhlungu esifubeni sakho
• ukushaya kwenhliziyo okusheshayo
• ububomvu noma ukukhipha okuzungeze imbobo

Imiphi imishanguzo engizoyiphuza ngemuva kokuhlinzwa kwenhliziyo?

Udokotela wakho uzokunika imithi yokusiza ukuphatha ubuhlungu bakho, njenge-ibuprofen (Advil) noma i-acetaminophen (iTylenol). Ungase futhi uthole i-narcotic yezinhlungu ezimbi kakhulu.

Udokotela wakho uzokunika nemithi yokukusiza kuyo yonke inqubo yakho yokutakula. Lokhu kuzobandakanya imishanguzo yama-antiplatelet nezinye izidakamizwa ezinikezwe udokotela wakho.

Khuluma nodokotela wakho mayelana nokuthi yiziphi izinhlelo zokwelapha ezingcono kakhulu kuwe. Lokhu kubaluleke kakhulu uma unezimo ezikhona ezifana nesifo sikashukela noma izimo ezithinta isisu noma isibindi.

Iyini imiphumela yesikhathi eside yokuhlinzwa okudlula?

Ngemuva kokuhlinzwa ngempumelelo kwenhliziyo, izimpawu ezifana nokuphefumula, ukuqina kwesifuba, nomfutho wegazi ophakeme kuzoba ngcono.

Ukudlula eceleni kungakhuphula ukugeleza kwegazi kuye enhliziyweni, kepha kungadingeka ukuthi ushintshe imikhuba ethile ukuvimbela isifo senhliziyo esizayo.

Imiphumela emihle kakhulu yokuhlinzwa iyabonakala kubantu abenza izinguquko zokuphila ngendlela enempilo. Khuluma nodokotela wakho mayelana nezinguquko zokudla nezinye izindlela zokuphila okufanele uzenze ngemuva kokuhlinzwa.